住院肺癌患者衰弱现况及影响因素分析  

Analysis on the occurrence and influencing factors of frailty in hospitalized patients with lung cancer

作　　者：李伟[1] 李宇青 陈琼[1] 石柯[1] Li Wei;Li Yuqing;Chen Qiong;Shi Ke(Department of Geriatrics,Xiangya Hospital,Central South University,National Clinical Research Center for Geriatric Disorders(Xiang Ya Hospital),Changsha 410008,China)

机构地区：[1]中南大学湘雅医院老年医学科,国家老年疾病临床研究中心(湘雅医院),长沙410008

出　　处：《中华老年医学杂志》2024年第11期1396-1401,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划项目(2020YFC2008600)。

摘　　要：目的探讨肺癌患者衰弱的发生现状及其影响因素。方法选取2022年3月至2023年3月在中南大学湘雅医院就诊且未进行抗肿瘤治疗的老年肺癌患者作为研究对象, 使用FRAIL量表将患者分为非衰弱组、衰弱前期组和衰弱组, 比较患者基本资料、疾病资料、相关实验室指标间的差异, 筛选肺癌患者衰弱发生的影响因素。结果共纳入肺癌患者240例, 其中非衰弱组有46例(19.2%)、衰弱前期组有121例(50.4%)、衰弱组有73例(30.4%)。衰弱组和衰弱前期组的年龄较非衰弱组高(P<0.05);衰弱组体质指数(BMI)较非衰弱组和衰弱前期组低(P=0.005);男性患者中衰弱者占比较女性低, 衰弱前期者占比较女性患者高(P=0.017);有亲属照料的患者中衰弱者和衰弱前期者占比均较无亲属照料者低(P<0.001);衰弱组患者的白细胞(WBC)、中性粒细胞(NEUT)、氨基末端脑钠肽前体(NT-proBNP)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、中性粒细胞与淋巴细胞计数比值(NLR)、单核细胞与淋巴细胞计数比值(MLR)、系统炎症指数(SII)均高于非衰弱组, 而红细胞(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、淋巴细胞(LYMPH)、总蛋白(TP)、白蛋白(Alb)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平均低于非衰弱组(均P<0.05);衰弱组患者的NEUT、NT-proBNP、NLR、MLR、SII与血小板和淋巴细胞计数比值(PLR)高于衰弱前期组, 而RBC、Hb、HCT、LYMPH、TP、Alb、TC、HDL-C、LDL-C低于衰弱前期组(均P<0.05);衰弱前期组的NT-proBNP高于非衰弱组(P<0.05);多因素Logistic回归分析结果显示, 男性与肺癌患者衰弱风险增加有关(OR=2.80、P=0.033), 亲属照料与肺癌患者衰弱的风险降低有关(OR=0.37、P=0.004), 年龄增加与肺癌患者衰弱的风险升高有关(OR=1.06、P=0.004);Alb水平升高与肺癌患者的衰弱风险降低有关(OR=0.91、P=0.023);LDL-C水平升高与肺癌患者的衰弱Objective To investigate the occurrence of frailty and its influencing factors in patients with lung cancer.Methods s Patients with lung cancer receiving treatment at Xiangya Hospital of Central South University were recruited between March 2022 and March 2023.The FRAIL scale was employed to categorize the patients into non-frailty,pre-frailty,and frailty groups.A comparison of their basic data,disease data,and relevant laboratory indicators before treatment was conducted to identify factors influencing frailty in lung cancer patients.ResultsA total of 240 patients with lung cancer were analyzed in this study,comprising 46 patients(19.2%)in the non-frailty group,121 patients(50.4%)in the pre-frailty group,and 73 patients(30.4%)in the frailty group.The average age of the frailty and pre-frailty groups was significantly higher than that of the non-frailty group(P<0.05).Additionally,the body mass index(BMI)of the frailty group was significantly lower compared to both the non-frailty and pre-frailty groups(P=0.005).The proportion of male patients in the frailty group was lower than that of female patients,while the proportion of pre-frailty patients was higher among females(P=0.017).Furthermore,the percentage of patients receiving family care was lower in both the frailty and pre-frailty groups compared to those without family care(P<o.001).Various blood markers such as white blood cells(WBC),neutrophils(NEUT),N terminal pro B type natriuretic peptide(NT-proBNP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),neurophil to lymphocyte ratio(NLR),monocyte-lymphocyte ratio(MLR),and systemic inflammatory index(Sl)were significantly elevated in the frailty group compared to the non-frailty group,whereas red blood cells(RBC),hemoglobin(Hb),hematocrit(HCT),lymphocytes(LYMPH),total protein(TP),albumin(Alb),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and lowdesity lipoprotein cholesterol(LDL-C)were notably lower in the frailty group(all P<o.05).Similarly,NEUT,NLR,platelet to lymphocyte ratio(PL

关 键 词：肺肿瘤 衰弱 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]